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Chlamydia (Chlamydia trachomatis) is the most commonly diagnosed bacterial sexually transmissible infection worldwide, with over 100 million cases diagnosed annually. Diagnoses have increased considerably over the last decade, with over 235 000 in the UK1 and over 80 000 in Australia.2 Most chlamydia diagnoses are among 15- to 29-year-olds and prevalence estimates suggest that ~3-5% of young adults are infected at any point in time.3,4 Chlamydia infection is asymptomatic in ~80% of people and, if untreated, potential consequences include pelvic inflammatory disease, ectopic pregnancy and infertility.5
In Australia, general practice plays a key role in the diagnosis and treatment of chlamydia.6,7 Most young people attend general practice at least once annually,7,8 making it an ideal setting for offering chlamydia testing to this population. Annual chlamydia testing for all sexually active people aged 15-29 years is recommended in the Royal Australian College of General Practitioners (RACGP) preventive health guidelines.9 Despite this, the proportion of 16- to 29-year-olds tested in Australian general practice is low (8.9%)8 with barriers to testing in general practice, such as time and workload demands; a lack of clinician knowledge, awareness and training; and concerns around 'offending' patients by offering chlamydia testing being identified as reasons for low uptake.10
The Australian Chlamydia Control Effectiveness Pilot (ACCEPt) is a world first cluster randomised controlled trial investigating the feasibility and effectiveness of a multifaceted intervention to increase chlamydia testing rates in general practice. An optional component of the ACCEPt intervention involves enhancing the role of practice nurses (PNs) in chlamydia testing. PNs are an integral part of Australian general practice, but their role in preventive care, including sexual health, is less established compared with countries such as the UK.11 However, in recent years, alongside increasing numbers and an expansion in scope of practice, PNs have demonstrated an interest in increasing their involvement in sexual health care.12,13
To facilitate their involvement in chlamydia testing, PNs have raised the importance of education and training;13 however, there are no published evaluations of the impact of education on PNs' chlamydia knowledge and attitudes. We thus aimed to examine the impact of a chlamydia education program on PNs' knowledge...